Ask Dr. Z

Greetings Dr. Zeilske or Dr.Dunn, We have lately started receiving denials from at least Humana, Cigna, and Tricare, maybe others, when reporting 36140, 36200, 36245-36248 when submitted with 75710 or 75716. We have recently found on the Humana website that on June 24, 2011 Humana has published an edit that "36140, 36200, 36245-36248 will not be separately reimbursed when submitted with 73706, 75635, 75710 or 75716". Are you familiar with any such edit or coding change that would support the insurance denials not to pay the cath placement with the diagnostic study? Our surgeons regularly perform the diagnostic angiograms and we of course report the catheter placement as well as the radiological supervision and interpretation. (of note, no cath is reported with interventions, of course. Cath only reported with the diagnostic studies). Thank you for any insight you may have to how / why the insurance carriers have developed this edit to deny the catheterization with 75710 / 75716. Thank you